Individual
MYRA ANN GERCKEN-THURSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3712 CARDINAL BLVD, DAYTONA BEACH, FL 32118-7204
(386) 290-2911
Mailing address
3712 CARDINAL BLVD, DAYTONA BEACH, FL 32118-7204
(386) 290-2911
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
108736147
SUPERVISOR OF ELECTIONS
FL
01
—
T62554763506-0
DRIVERS LIC
FL
Enumeration date
02/03/2023
Last updated
02/03/2023
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